Tocilizumab, Adipokines and Severe Complications of COVID-19

Fioravanti, Antonella; Porcelli, Brunetta; Terzuoli, Lucia; Bacarelli, Maria Romana; Tenti, Sara; Cheleschi, Sara

doi:10.1007/s40261-020-00950-2

Cited by 7 publications

(11 citation statements)

References 14 publications

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“…Also, we had the advantage of well-defined guidelines created both at the central level by the government and at the respective hospital level. A large number of therapies such as use of convalescent sera, anti-viral drugs like remdesivir (21,22,23) and antibody against IL-6 receptors (Tocilizumab (24,25) ) were already tried and proven to be efficacious in multiple centers across the globe. Since this data is only for the first 1000 patients, remdesivir was not used due to unavailability.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience

Budhiraja

Soni

Jha

et al. 2020

Preprint

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ObjectiveTo describe the clinical profile and factors leading to increased mortality in coronavirus disease (COVID-19) patients admitted to a group of hospitals in India.DesignA records-based study of the first 1000 patients with a positive result on real-time reverse transcriptase-polymerase-chain-reaction assay for SARS-CoV-2 admitted to our facilities. Various factors such as demographics, presenting symptoms, co-morbidities, ICU admission, oxygen requirement and ventilator therapy were studied.ResultsOf the 1000 patients, 24 patients were excluded due to lack of sufficient data. Of the remaining 976 in the early phase of the epidemic, males were admitted twice as much as females (67.1% and 32.9%, respectively). Mortality in this initial phase was 10.6% and slightly higher for males and steeply higher for older patients. More than 8% reported no symptoms and the most common presenting symptoms were fever (78.3%), productive cough (37.2%), and dyspnea (30.64%). More than one-half (53.6%) had no co-morbidity. The major co-morbidities were hypertension (23.7%), diabetes without (15.4%), and with complications (9.6%). The co-morbidities were associated with higher ICU admissions, greater use of ventilators as well as higher mortality. A total of 29.9% were admitted to the ICU, with a mortality rate of 32.2%. Mortality was steeply higher in those requiring ventilator support (55.4%) versus those who never required ventilation (1.4%). The total duration of hospital stay was just a day longer in patients admitted to the ICU than those who remained in wards.ConclusionMale patients above the age of 60 and with co-morbidities faced the highest rates of mortality. They should be admitted to the hospital in early stage of the disease and given aggressive treatment to help reduce the morbidity and mortality associated with COVID-19.

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Section: Comparison With Other Studiesmentioning

confidence: 99%

Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience

Budhiraja

Soni

Jha

et al. 2020

Preprint

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“…We thank Fioravanti et al [ 1 ] for their comments regarding our article on the use of tocilizumab in the treatment of novel coronavirus pneumonia (COVID-19) [ 2 ]. The article highlighted the possibility that tocilizumab may inhibit the occurrence and development of a cytokine storm by regulating adipokines, such as adiponectin, and inducing antithrombotic/fibrinolytic effects by regulating chemerin in patients with obesity with COVID-19 [ 1 ]. The ideas are relatively novel, and we are interested in discussing the viewpoint of this article on the basis of the existing evidence.…”

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confidence: 99%

“…Adipokines are cytokines secreted mainly by white adipose tissue, involved in inflammation, endothelial dysfunction, and atherosclerosis, and may be a molecular link between rheumatoid arthritis, metabolic syndrome, and the risk of cardiovascular disease [ 15 , 16 ]. As described in Fioravanti et al’s article [ 1 ], adiponectin is an adipokine with insulin-sensitizing and anti-atherogenic properties. Hypoadiponectinemia has been shown to be associated with obesity, diabetes, metabolic inflammatory syndrome, and inflammation [ 17 , 18 ].…”

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confidence: 99%

“…Hypoadiponectinemia has been shown to be associated with obesity, diabetes, metabolic inflammatory syndrome, and inflammation [ 17 , 18 ]. Furthermore, low serum levels of adiponectin were reported as predictor of mortality in critically ill patients in intensive care units [ 1 ]. Leptin has pro-inflammatory properties stimulating the production of tumor necrosis factor-α, IL-6, and IL-12.…”

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confidence: 99%

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Authors’ Reply to: Tocilizumab, Adipokines and Severe Complications of COVID-19

Liu

2020

Clin Drug Investig

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“…Tocilizumab is currently used for a variety of immune system diseases; however, it recently obtained a new indication for the treatment of CRS induced by CAR-T cell therapy [ 6 ]. To date, no therapy has been approved for the treatment of COVID-19, but targeting IL-6 with tocilizumab treatment could be a potential therapeutic option for patients with COVID-19-induced CRS [ 3 , 7 – 10 ].…”

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confidence: 99%